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Temporary Severe Neutropenia during Administration of Atezolizumab: A Novel Case Report
Here, we describe a case of temporary severe neutropenia after atezolizumab monotherapy and its treatment course. Atezolizumab monotherapy was introduced as a 6th-line treatment for a man in his late 60s, who was diagnosed with stage Ⅳ lung adenocarcinoma. The first treatment cycle was administered...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
S. Karger AG
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10293966/ https://www.ncbi.nlm.nih.gov/pubmed/37384199 http://dx.doi.org/10.1159/000530338 |
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author | Kanno, Ryota Saito, Yoshitaka Takekuma, Yoh Asahina, Hajime Sugawara, Mitsuru |
author_facet | Kanno, Ryota Saito, Yoshitaka Takekuma, Yoh Asahina, Hajime Sugawara, Mitsuru |
author_sort | Kanno, Ryota |
collection | PubMed |
description | Here, we describe a case of temporary severe neutropenia after atezolizumab monotherapy and its treatment course. Atezolizumab monotherapy was introduced as a 6th-line treatment for a man in his late 60s, who was diagnosed with stage Ⅳ lung adenocarcinoma. The first treatment cycle was administered during hospitalization, and the patient presented with a fever of 37.8°C on the first day. The fever resolved after the administration of acetaminophen and naproxen, and the white blood cell count, neutrophil count, and other white blood cell fractions were normal. However, grade 3 leukopenia and grade 4 neutropenia appeared at the beginning of the third cycle, and treatment was discontinued. After treatment, monocyte count in the leukocyte fraction increased from approximately 10% to 25.6%. Lenograstim 100 μg subcutaneous injection and oral levofloxacin 500 mg once daily were started of onset of neutropenia, and he was hospitalized the next day. Laboratory findings upon admission showed a significant improvement to 5,300/µL for leukocytes and 3,376/µL for neutrophils. Lenograstim was discontinued, with no further decrease in the neutrophil count. Atezolizumab therapy was resumed, and there was no further reduction in leukocyte, neutrophil, or leukocyte fractions over about a 2-year period. Concomitant drugs were maintained during the atezolizumab treatment, suggesting that they did not induce neutropenia. In conclusion, we observed temporary severe neutropenia during atezolizumab monotherapy. Neutrophil recovery with cautious monitoring has enabled longer efficacy. We should consider temporary symptom occurrence in cases of haematological immune-related adverse events. |
format | Online Article Text |
id | pubmed-10293966 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | S. Karger AG |
record_format | MEDLINE/PubMed |
spelling | pubmed-102939662023-06-28 Temporary Severe Neutropenia during Administration of Atezolizumab: A Novel Case Report Kanno, Ryota Saito, Yoshitaka Takekuma, Yoh Asahina, Hajime Sugawara, Mitsuru Case Rep Oncol Case Report Here, we describe a case of temporary severe neutropenia after atezolizumab monotherapy and its treatment course. Atezolizumab monotherapy was introduced as a 6th-line treatment for a man in his late 60s, who was diagnosed with stage Ⅳ lung adenocarcinoma. The first treatment cycle was administered during hospitalization, and the patient presented with a fever of 37.8°C on the first day. The fever resolved after the administration of acetaminophen and naproxen, and the white blood cell count, neutrophil count, and other white blood cell fractions were normal. However, grade 3 leukopenia and grade 4 neutropenia appeared at the beginning of the third cycle, and treatment was discontinued. After treatment, monocyte count in the leukocyte fraction increased from approximately 10% to 25.6%. Lenograstim 100 μg subcutaneous injection and oral levofloxacin 500 mg once daily were started of onset of neutropenia, and he was hospitalized the next day. Laboratory findings upon admission showed a significant improvement to 5,300/µL for leukocytes and 3,376/µL for neutrophils. Lenograstim was discontinued, with no further decrease in the neutrophil count. Atezolizumab therapy was resumed, and there was no further reduction in leukocyte, neutrophil, or leukocyte fractions over about a 2-year period. Concomitant drugs were maintained during the atezolizumab treatment, suggesting that they did not induce neutropenia. In conclusion, we observed temporary severe neutropenia during atezolizumab monotherapy. Neutrophil recovery with cautious monitoring has enabled longer efficacy. We should consider temporary symptom occurrence in cases of haematological immune-related adverse events. S. Karger AG 2023-05-24 /pmc/articles/PMC10293966/ /pubmed/37384199 http://dx.doi.org/10.1159/000530338 Text en © 2023 The Author(s). Published by S. Karger AG, Basel https://creativecommons.org/licenses/by-nc/4.0/This article is licensed under the Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC) (http://www.karger.com/Services/OpenAccessLicense). Usage and distribution for commercial purposes requires written permission. |
spellingShingle | Case Report Kanno, Ryota Saito, Yoshitaka Takekuma, Yoh Asahina, Hajime Sugawara, Mitsuru Temporary Severe Neutropenia during Administration of Atezolizumab: A Novel Case Report |
title | Temporary Severe Neutropenia during Administration of Atezolizumab: A Novel Case Report |
title_full | Temporary Severe Neutropenia during Administration of Atezolizumab: A Novel Case Report |
title_fullStr | Temporary Severe Neutropenia during Administration of Atezolizumab: A Novel Case Report |
title_full_unstemmed | Temporary Severe Neutropenia during Administration of Atezolizumab: A Novel Case Report |
title_short | Temporary Severe Neutropenia during Administration of Atezolizumab: A Novel Case Report |
title_sort | temporary severe neutropenia during administration of atezolizumab: a novel case report |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10293966/ https://www.ncbi.nlm.nih.gov/pubmed/37384199 http://dx.doi.org/10.1159/000530338 |
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